Skip to main content

Remdesivir use while Breastfeeding

Medically reviewed by Drugs.com. Last updated on Apr 21, 2022.

Remdesivir Levels and Effects while Breastfeeding

Summary of Use during Lactation

Information from one patient indicates that milk levels of remdesivir and its active metabolite are very low in milk. Additionally, remdesivir is poorly absorbed orally, and the metabolite is only partially absorbed orally, so infants are not likely to absorb clinically important amounts of the drug from milk. Newborn infants have received intravenous remdesivir therapy for Ebola and for COVID-19 with no serious adverse drug reactions.[1-3] Given this limited information, it does not appear that mothers receiving remdesivir need to avoid nursing, but until more data are available, remdesivir should be used with careful infant monitoring during breastfeeding.[4] The most common adverse effects reported after intravenous infusion include elevated aminotransferase and bilirubin levels and other liver enzyme elevations, diarrhea, rash, renal impairment and hypotension.

Drug Levels

Maternal Levels. Two days after delivery, a woman was diagnosed with a SARS-CoV-2 infection. She was given 200 mg of remdesivir on the first day of therapy, then 100 mg daily for 4 more days. Although not stated, all doses are presumed to have been given intravenously. On day 5 of therapy, milk was collected just before the dose and 1, 3, 6, and 24 hours after the last dose. Remdesevir and its metabolite GS-441524 were measured in milk. The concentration of remdesivir in milk was 1.29 mcg/L one hour before administration on day 5, but undetectable (<0.5 mcg/L) in the other samples. The concentration of the active metabolite GS-441524 in the milk samples were 13.5 mcg/L before the fifth dose, 285 mcg/L at 3 hours after the dose and 64.3 mcg/L at 24 hours after the dose. The authors estimated the relative infant doses of remdesevir and GS-441524 in breastmilk as 0.007% and 1.6%, respectively. The half-life of GS-441524 in milk was estimated to be 9.3 hours.[5]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Bebtelovimab, Nirmatrelvir, Sotrovimab

References

1.
Dörnemann J, Burzio C, Ronsse A, et al. First newborn baby to receive experimental therapies survives Ebola virus disease. J Infect Dis. 2017;215:171–4. [PMC free article: PMC5583641] [PubMed: 28073857]
2.
Mulangu S, Dodd LE, Davey RT Jr, et al. A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med. 2019;381:2293–303. [PubMed: 31774950]
3.
Frauenfelder C, Brierley J, Whittaker E, et al. Infant with SARS-CoV-2 infection causing severe lung disease treated with remdesivir. Pediatrics. 2020;146:e20201701. [PubMed: 32554811]
4.
Aleissa MM, Silverman EA, Paredes Acosta LM, et al. New perspectives on antimicrobial agents: Remdesivir treatment for COVID-19. Antimicrob Agents Chemother. 2021;65:e01814–20. [PMC free article: PMC7927874] [PubMed: 33139290]
5.
Wada YS, Saito J, Hashii Y, et al. Remdesivir and human milk: A case study. J Hum Lact. 2022;38:248–51. [PubMed: 35189734]

Substance Identification

Substance Name

Remdesivir

CAS Registry Number

1809249-37-3

Drug Class

Breast Feeding

Lactation

Milk, Human

Antimetabolites

Antiviral Agents

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.